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Articles 271 - 300 of 16252
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Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould
Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project evaluated the impact of a structured staff educational intervention on ambulatory surgery center (ASC) staff knowledge of Universal Protocol and SOAP (Surgeon, Operating Room, Anesthesia, and Preprocedure Ready) documentation. A practice gap was identified in staff knowledge of perioperative safety processes that are essential for preventing surgical safety events. The purpose of this doctoral project was to improve ASC staff knowledge of Universal Protocol and SOAP readiness documentation through an evidence-based educational intervention designed to strengthen perioperative safety practices. The practice-focused question was: According to the evidence, in multi-specialty ASC staff, what is …
Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes
Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes
Walden Dissertations and Doctoral Studies
Perceptions of safety and emotional support during involvement with child protective services (CPS) during adolescence may play a significant role in shaping attachment experiences and relationships in adulthood. Although researchers have examined the effects of child maltreatment and foster care involvement, limited research has explored how adolescents perceive emotional support and safety during CPS involvement and how those experiences influence attachment in adulthood. The purpose of this qualitative study was to explore the lived experiences of adults who experienced CPS involvement during adolescence and to understand how perceptions of safety and emotional support are reflected in their adult attachment relationships. …
Training Strategies For Employees To Use Electronic Human Resource Management Systems, Anita Wright
Training Strategies For Employees To Use Electronic Human Resource Management Systems, Anita Wright
Walden Dissertations and Doctoral Studies
Ineffective electronic human resource management (e-HRM) training can weaken HR employees’ ability to use digital human resource (HR) systems that support HR operations, employee services, and workplace efficiency. HR managers in small to medium-sized enterprises (SMEs) recognize that poor e-HRM training undermines employees’ confidence, consistency, and accuracy in HR tasks. Grounded in the technology acceptance model (TAM), the purpose of this qualitative pragmatic inquiry project was to identify and explore the effective strategies some SME HR managers use to train HR employees to use e-HRM systems. The participants were eight SME HR managers in the southeastern United States with experience …
Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi
Reducing Urinary Tract Infections In Long-Term Care Residents, Felicity Antwi
Walden Dissertations and Doctoral Studies
This quality improvement (QI) project addressed delays in diagnosing urinary tract infections (UTIs) at a skilled nursing facility (SNF), where reliance on urine culture testing and patient monitoring resulted in an average diagnostic period of 72 hours. A high UTI incidence and UTI-involved hospitalization rate are both nurse-sensitive indicators that are important to address in the nursing practice context because they portend negatively for nursing quality and safety. This quality improvement (QI) project addressed the practice-focused question: among long term care (LTC) residents with suspected UTIs in a nursing home (NH), how does reducing the diagnostic period from 72 hours …
Innovation And Control In Curriculum Reform: An Autobiographical Inquiry From A Seoul Future Innovation School, Sunyoung Kim
Innovation And Control In Curriculum Reform: An Autobiographical Inquiry From A Seoul Future Innovation School, Sunyoung Kim
Journal of Educational Research and Practice
This autobiographical inquiry examines the lived experience of a teacher–researcher navigating curriculum reform within a centralized education system during her first year at a Seoul Future Innovation School. The study explores how policy ideals of curriculum autonomy, innovation, and student-centered learning encounter institutional realities of documentation, compliance, and performative accountability. Drawing on reflective journals and narrative reconstruction, the analysis identifies four tensions shaping reform enactment: the gap between reform discourse and school culture, the symbolic labeling of innovation, technocentric expectations that narrow curricular legitimacy, and the emotional labor of navigating stakeholder demands. The study illustrates how institutional conditions both constrain …
Staff Education To Improve Mindfulness Knowledge Among Rns, Nps, And Mas In A Behavioral Health Setting, Barbara Buxton
Staff Education To Improve Mindfulness Knowledge Among Rns, Nps, And Mas In A Behavioral Health Setting, Barbara Buxton
Walden Dissertations and Doctoral Studies
Burnout is a recurrent problem for healthcare workers and is associated with staff turnover, a decline in the quality of care, emotional fatigue, and risks to patient safety. This Doctor of Nursing Practice (DNP) staff education initiative created a mindfulness-based training program to expand the knowledge of registered nurses, nurse practitioners, and medical assistants on mindfulness practices in a behavioral health setting. Baseline assessment data identified a need for support to address emotional fatigue, absenteeism, and staff disengagement, with a mean pre‑education knowledge score of 66%. A structured, in‑person educational program addressing burnout awareness, stress reactivity, and helpful mindfulness methods …
A Multifaceted Surgical Suite Quality Improvement Initiative, George Tazvitya Mhosira
A Multifaceted Surgical Suite Quality Improvement Initiative, George Tazvitya Mhosira
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project focuses on modernizing an acute care hospital’s surgical suite, enhancing environmental safety, and supporting the growing complexity of surgical care. As surgical procedures become more advanced, the physical environment must evolve to maintain sterile technique and reduce microbial presence. Current operating room configuration, characterized by overcrowding and outdated ventilation systems, introduces environmental risks that compromise patient safety and limit perioperative efficiency. Modernization is essential to align the surgical environment with contemporary safety expectations and organizational performance goals. The proposed initiative includes a comprehensive renovation and expansion of surgical spaces, integrating advanced air decontamination technologies, …
Improving Adolescent Antidepressant Medication Adherence In An Outpatient Psychiatric Clinic Through Teach-Back And Motivational Interviewing, Sandra Ajao
Walden Dissertations and Doctoral Studies
Antidepressant medication adherence among adolescents is a significant concern in outpatient psychiatric care. Adolescents may miss doses because of stigma, forgetfulness, side effects, limited understanding of medication instructions, or inconsistent caregiver support. The purpose of this Doctor of Nursing Practice project was to improve antidepressant medication adherence and adherence-focused communication among adolescents in an outpatient psychiatric clinic through staff education on teach-back and motivational interviewing. The practice-focused question examined how teach-back combined with motivational interviewing, compared with usual care, affected medication adherence and depressive symptoms during the implementation period. Staff education included use of a previsit questionnaire, structured visit script, …
Staff Education To Improve Whiteboard Utilization To Focus On Nurse Communication And Patient Experience On A Medical-Surgical Unit, Charline J. Bethea
Staff Education To Improve Whiteboard Utilization To Focus On Nurse Communication And Patient Experience On A Medical-Surgical Unit, Charline J. Bethea
Walden Dissertations and Doctoral Studies
Inconsistent use of standardized whiteboards in patient rooms may contribute to ineffective nurse communication and lower patient experience scores. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether an evidence-based staff education program improved nursing knowledge, intent to use standardized whiteboards, and whiteboard utilization on a medical-surgical unit. Guided by the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) instructional design model, the intervention included a standardized educational presentation, pre- and post-education knowledge assessments, a workflow integration guide, competency validation, and weekly compliance audits. Thirty-five staff members, including registered nurses and patient care technicians, participated in the project. Following …
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Walden Dissertations and Doctoral Studies
Lyme disease (LD), a tick-borne illness, has been a growing concern in the state of Tennessee. Studies have established environmental concerns regarding a growing tick population and identified a gap between reported cases and disease burden in Tennessee. Despite this information, it remains classified as a low-incidence reporting state, raising concerns about underreporting that indicate an ineffective current surveillance system. Because the public perception regarding surveillance of LD is unknown, the purpose of this qualitative study was to explore how adults in Tennessee perceived LD as a credible public health threat within the context of the current surveillance system. Guided …
Early Childhood Teachers’ Perceptions Of Early Childhood Teacher Leadership, Their Leadership Experiences, And Teacher Leadership Skill Development, Danyle Watkins
Walden Dissertations and Doctoral Studies
The problem that was addressed in this study is that research into early childhood leadership has focused on early childhood directors and programs for leadership, but little research has been conducted on early childhood teachers’ (ECTs’) perceptions of the ECT leadership. Guided by the McCormick Center Whole Leadership Framework, the purpose of this basic qualitative study was to explore ECTs’ perceptions on characteristics of teachers as leaders, their leadership experiences, and their leadership skill development in a Midwestern U.S. state. Data were collected through semistructured interviews with 10 ECTs employed in licensed early childhood centers serving children from birth through …
Emergency Nurses' Perceptions Of Interpersonal Empathy When Caring For Department Superusers, Makeba K. Cavette
Emergency Nurses' Perceptions Of Interpersonal Empathy When Caring For Department Superusers, Makeba K. Cavette
Walden Dissertations and Doctoral Studies
Compassion fatigue syndrome (CFS) is a significant challenge for healthcare professionals, particularly nurses in the emergency department (ED), due to the demanding, high-pressure nature of their work environment and their increased exposure to human suffering. The purpose of this qualitative phenomenological descriptive study, guided by Nursing Theory of Personal Empathy, was to describe the meaning of ED nurses' interactions with superuser patients and how these interactions affect ED nurses' empathy and susceptibility to developing CFS. A purposive sample of 8 ED nurses with at least 3 years of experience as ED staff nurses working with superuser patients participated in semistructured …
The Relationship Between Employees’ Involvement, Process Improvement, And Customer Satisfaction In Manufacturing Industries, Nawres Fouad
The Relationship Between Employees’ Involvement, Process Improvement, And Customer Satisfaction In Manufacturing Industries, Nawres Fouad
Walden Dissertations and Doctoral Studies
Customer satisfaction remains a challenge for some manufacturing organizations despite the widespread implementation of TQM practices. Manufacturing leaders must improve customer satisfaction because it enhances customer retention, organizational competitiveness, and long-term business performance. The purpose of this quantitative correlational study was to examine the relationships between employees' involvement, process improvement, and customer satisfaction. The expectancy-disconfirmation theory grounded the research project. Participants were 68 middle managers employed in manufacturing organizations in Ontario, Canada. Data were collected through an anonymous online survey using the Utrecht Work Engagement Scale (UWES-9) and the TQM Practices Scale. The data were analyzed using descriptive statistics, Cronbach’s …
Staff Education To Improve Depression Screening And Management Using Phq-9, Elizabeth Aja
Staff Education To Improve Depression Screening And Management Using Phq-9, Elizabeth Aja
Walden Dissertations and Doctoral Studies
This doctoral project was a staff education initiative. It was motivated by the realization that depression is often under-recognized when standardized screening practices are not consistently implemented. The identified practice gap was inconsistent administration, interpretation, and documentation of the PHQ-9 by the nursing staff. The practice-focused question examined whether a staff education intervention would improve nurses’ knowledge and confidence in using the PHQ-9 for depression screening. The purpose of the project was to implement and evaluate an evidence-based educational program on PHQ-9 administration, scoring, interpretation, and documentation. Data analysis included descriptive statistics on pretest and posttest scores from 14 participating …
Predictive Analytics For Nurse Staffing Optimization And Patient Outcomes, Rhonda Lynn Fisher
Predictive Analytics For Nurse Staffing Optimization And Patient Outcomes, Rhonda Lynn Fisher
Walden Dissertations and Doctoral Studies
This evidence-based quality improvement project assessed the use of a Predictive Analytics Staffing Decision-Support Tool (PASDST) to enhance nurse staffing alignment, workforce planning, and patient outcomes in an acute care setting. Traditional staffing relied mainly on historical census data and fixed nurse-to-patient ratios, with limited real-time information on admissions, discharges, census, and patient acuity. Guided by the Johns Hopkins Evidence-Based Practice Model, a 12-week pilot of PASDST was conducted on one acute care unit. Baseline data from 30 stakeholders—five nurse managers and 25 bedside nurses—were collected. Quantitative responses were analyzed via frequencies and percentages, while open-ended responses underwent thematic analysis. …
Improving Suicide Risk Identification Through Standardized Implementation Of The Columbia–Suicide Severity Rating Scale (C-Ssrs) In An Adult Outpatient Behavioral Health Setting, Mirabel Ngwe Boma
Walden Dissertations and Doctoral Studies
Suicide risk may fluctuate throughout treatment, making ongoing assessment essential for timely identification and intervention. At the project site, an adult outpatient behavioral health practice, the Columbia–Suicide Severity Rating Scale (C-SSRS) was administered consistently at intake but inconsistently at follow-up visits, creating gaps in suicide risk reassessment and documentation. The purpose of this quality improvement project was to evaluate the effect of standardized implementation of the C-SSRS during intake and follow-up visits on suicide risk screening compliance over a 9-week period. The practice-focused question asked how standardized implementation of the C-SSRS, compared with current practice, affected suicide risk screening compliance …
An Exploration Of Successful Cloud Database Migration Strategies Used By Small And Medium-Sized Enterprises Leaders In The United States, Ashli Jarrett
Walden Dissertations and Doctoral Studies
Cloud database migration can improve organizational performance in small and medium-sized enterprises (SMEs), but SME leaders are concerned about ineffective migration strategies, which can increase risks to data security, regulatory compliance, and operational continuity. Grounded in diffusion of innovation theory, the purpose of this qualitative pragmatic inquiry project was to explore the effective strategies SME leaders use to manage secure cloud database migrations, mitigate risks, enhance data security, ensure regulatory compliance, and improve organizational effectiveness. The participants were 10 SME leaders in the United States who had successfully adopted cloud-based database systems. Data were collected through semistructured interviews and publicly …
Implementation Of Standardized Suicide Risk Screening With Staff Education In An Outpatient Psychiatric Clinic, Gwendoline Nfotiog
Implementation Of Standardized Suicide Risk Screening With Staff Education In An Outpatient Psychiatric Clinic, Gwendoline Nfotiog
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was a quality improvement staff education initiative focused on improving suicide risk screening and documentation in an outpatient psychiatric clinic. Inconsistent use of validated screening tools and documentation practices created risks for missed identification of patients at risk for suicide. Addressing this gap was essential to improve patient safety and support evidence-based behavioral healthcare. In the project, I examined whether implementing standardized suicide risk screening with staff education would improve screening and documentation consistency over 12 weeks. The purpose was to increase staff knowledge, screening compliance, and documentation accuracy. Pre- and postimplementation chart audits, …
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Walden Dissertations and Doctoral Studies
Emerging infectious diseases continue to challenge national health systems, particularly in small island developing states with limited preparedness resources. Limited evidence comparing the International Health Regulations (2005) State Party Self-Assessment Annual Reporting (IHR SPAR) capacities of small island developing states with those of high-income countries limits efforts to identify preparedness gaps and strengthen health systems. The purpose of this quantitative comparative study was to evaluate Saint Lucia's preparedness using IHR SPAR indicators, compare its preparedness with the United States, and assess changes between 2023 and 2024. Guided by the World Health Organization Health System Framework, a quantitative cross-sectional design using …
Phenomenological Exploration Of The Military Veterans' Experiences Transitioning Into Civilian Workplace In Central Florida, James Wesley Shelton
Phenomenological Exploration Of The Military Veterans' Experiences Transitioning Into Civilian Workplace In Central Florida, James Wesley Shelton
Walden Dissertations and Doctoral Studies
Military veterans transitioning from military service to civilian employment frequently encounter challenges related to workforce integration, translating military-acquired skills, adapting to civilian workplace cultures, and employer perceptions of their qualifications. Organizational leaders need to understand these challenges as a key indicator of the factors that influence successful workforce integration, organizational commitment, and employee retention. Grounded in person-environment fit theory, the purpose of this qualitative study using an interpretative phenomenological analysis (IPA) approach was to explore the lived experiences of military veterans and how they make meaning of their transition to the civilian workplace. The participants comprised seven U.S. military veterans …
Effective Strategies For Accessing Capital For Startup Agricultural Entrepreneurs In St. Vincent And The Grenadines, Tonya Pompey
Effective Strategies For Accessing Capital For Startup Agricultural Entrepreneurs In St. Vincent And The Grenadines, Tonya Pompey
Walden Dissertations and Doctoral Studies
Limited access to capital is a significant barrier to market entry and long term sustainability in the agricultural industry. Agricultural business owners consistently identify capital constraints as the leading predictor of startup failure. Grounded in institutional theory, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies that agricultural startup business owners used to access capital for market entry and business sustainability. The participants were six agricultural startup entrepreneurs in St. Vincent and the Grenadines (SVG) who used effective strategies to access capital for market entry and sustained business operations for at least 2 years. Data …
Effective Strategies To Improve Ai Governance And Regulatory Compliance, Mursal Haroon
Effective Strategies To Improve Ai Governance And Regulatory Compliance, Mursal Haroon
Walden Dissertations and Doctoral Studies
Senior business leaders across sectors face increasing risks because many organizations lack effective strategies to ensure transparency and regulatory accountability in artificial intelligence (AI) governance. This problem is critical for industry leaders who rely on transparent and compliant AI systems to protect consumers and maintain operational stability. Grounded in the ethical usage of AI systems, the purpose of this qualitative pragmatic study was to explore effective strategies senior business leaders use to improve transparency and regulatory accountability in AI governance. The participants were six senior business leaders in the United States who successfully implemented such strategies. Data were collected through …
Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti
Staff Education On The Implementation Of An Evidence-Based, Suicide-Risk-Assessment Education Program For Psychiatric Staff, Yemurai Emily Dzikiti
Walden Dissertations and Doctoral Studies
Suicide is a major public health concern, and consistent suicide risk assessment is essential for patient safety in psychiatric settings. This Doctor of Nursing Practice staff education project addressed a knowledge gap in evidence-based suicide risk assessment among psychiatric clinicians in an outpatient mental health setting. The practice-focused question examined whether an evidence-based suicide risk assessment education program would improve clinicians' knowledge from pre- to post-education. The educational intervention consisted of a 60-minute in-person training session on evidence-based suicide risk assessment using the Columbia-Suicide Severity Rating Scale (C-SSRS) and the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) framework. Ten psychiatric …
Social Workers’ Lived Experiences Of Trauma-Informed Training, Ashley Ann Johnson
Social Workers’ Lived Experiences Of Trauma-Informed Training, Ashley Ann Johnson
Walden Dissertations and Doctoral Studies
Social workers report limited formal training in trauma-informed approaches, and implementation of trauma-informed care varies widely across settings, with inconsistent training uptake and organizational support for sustained practice change. The purpose of this qualitative phenomenological study was to explore the lived experiences of social workers in trauma-informed training. The study was guided by trauma-informed care principles and an experiential learning framework. The research question examined how social workers develop trauma-informed competence and how systemic factors influence practice. Data were collected through 11 semi structured interviews with social workers and analyzed using thematic analysis. Three key themes emerged: (a) trauma-informed competence …
Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards
Evaluation Of A Streamlined Insurance Advocacy And Pre-Authorization Process For Hormone Replacement Therapy, Ellison Edwards
Walden Dissertations and Doctoral Studies
This organizational process evaluation project addressed the high rate of insurance denials for hormone replacement therapy (HRT) for women with symptomatic menopause and "normal" laboratory values within a private primary care setting. The practice problem involved bureaucratic barriers in the front office and a lack of structured advocacy, which delayed patient access to evidence-based care. The purpose of this project was to evaluate the impact of a streamlined insurance advocacy and pre-authorization process on access to therapy. The project utilized a standardized "Insurance Advocacy Toolkit" and evidence-based templates aligned with the 2023 North American Menopause Society (NAMS) guidelines. Analytical strategies …
Improving Post-Rehabilitation Discharge Outcomes Through A Care Coordination Bundle, Cavene Facey
Improving Post-Rehabilitation Discharge Outcomes Through A Care Coordination Bundle, Cavene Facey
Walden Dissertations and Doctoral Studies
Hospital readmissions remain a significant quality and patient safety concern across the United States, particularly among patients transitioning from rehabilitation settings to home or community-based care. Ineffective care transitions, fragmented communication, inconsistent discharge planning, and inadequate follow-up contribute to preventable hospital readmissions, increased healthcare costs, and poorer patient outcomes. Evidence consistently demonstrates that structured transitional care interventions and standardized care coordination processes improve continuity of care while reducing readmissions and enhancing patient satisfaction The purpose of this Doctor of Nursing Practice (DNP) project was to develop an evidence-based Clinical Practice Guideline (CPG) designed to improve post-rehabilitation discharge outcomes through implementation …
A Proposal For A Nurse-Led Continuity Of Care Program, Belinda Siri Mesape
A Proposal For A Nurse-Led Continuity Of Care Program, Belinda Siri Mesape
Walden Dissertations and Doctoral Studies
At an outpatient primary care and behavioral health clinic, the practice problem is the high rate of patient no-shows and late appointment cancellations. Missed appointments are a problem, disrupting continuity of care and follow-up and potentially affecting patient outcomes. A comprehensive literature search was performed using PubMed/MEDLINE, CINAHL Complete, the Cochrane Library, PsycINFO, and Google Scholar. The search revealed 26 peer-reviewed studies. Literature consistently supports the use of multifaceted interventions to improve appointment adherence in outpatient settings. The project proposal consists of the development of an evidence-based practice (EBP) program proposal to address the gap in practice in improving appointment …
Alcohol Withdrawal Management Practices And Prevention Of Escalation Events In Hospitalized Adults, Danielle Logan
Alcohol Withdrawal Management Practices And Prevention Of Escalation Events In Hospitalized Adults, Danielle Logan
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice project was an organizational process evaluation examining alcohol withdrawal management among hospitalized adults. Alcohol withdrawal can cause severe agitation, seizures, delirium, behavioral emergencies, transfers, and prolonged hospitalization, making early recognition and evidence-based management essential to patient safety. The practice-focused question examined whether hospitalized adults experiencing alcohol withdrawal were assessed and treated proactively based on risk factors and clinical presentation or reactively after symptom escalation, and whether management practices contributed to Code Green activation and higher-level-of-care transfers. The purpose was to identify practice gaps and develop evidence-based recommendations to improve safety and consistency of care. A …
The Impact Of Risk Management Strategies On Financial Forecasting In Small Businesses, Lakisha Hatcher
The Impact Of Risk Management Strategies On Financial Forecasting In Small Businesses, Lakisha Hatcher
Walden Dissertations and Doctoral Studies
Many small businesses are prone to fail because of ineffective or non-existing financial risk management practices. This problem is important to small business owners because ineffective risk management can hinder financial forecasting, decision-making, and long-term operational sustainment. The purpose of this qualitative pragmatic inquiry is to explore effective financial risk management strategies used by small business owners to identify and mitigate risk to improve financial risk management activities. The conceptual framework was enterprise risk management. The participants consisted of seven service-based small business owners located in Central Maryland who successfully implemented financial risk management practices. Data were collected through semistructured …
Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Improving Intake Efficiency In Inpatient Behavioral Health Facilities To Reduce Delays In Care, Lakisha Brown
Walden Dissertations and Doctoral Studies
Delays in inpatient psychiatric admissions represent a significant and persistent challenge within U.S. behavioral health systems, contributing to emergency department boarding, reduced quality of care, increasing risk, resource strain, and inefficiencies. The purpose of this integrative review was to examine evidence-based operational strategies that improve intake efficiency and reduce admission delays in inpatient behavioral health facilities. The Lean Healthcare Framework was used, which emphasizes eliminating waste, improving workflow efficiency, and enhancing value. The review question focused on what operational and systems-management evidence-based strategies are most effective in improving intake efficiency. The Johns Hopkins Evidence-Based Practice appraisal tool was used to …